Provider Demographics
NPI:1508634353
Name:YELLIN, EMILY SARAH (MS, RDN, CDRN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:SARAH
Last Name:YELLIN
Suffix:
Gender:F
Credentials:MS, RDN, CDRN
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:GELLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14728 71ST AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2009
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14728 71ST AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-2009
Practice Address - Country:US
Practice Address - Phone:516-526-7053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011635133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered